Maybe David Kirby, author of Evidence of Harm and one of the major proponents of the notion that thimerosal in vaccines was largely responsible for the recent increase in autism diagnoses, is sincere when he claims he is not anti-vaccine. I say that because he has backed so far off from his stance that vaccines are the culprit – not completely, and without overtly acknowledging his past errors, but has put some significant distance between him current position and his prior certainty.

In his 2005 book Kirby asks the question:

Did the injection of organic mercury directly into the developing systems of small children cause irreparable harm? It’s a plausible proposition, and a hugely important question. If the answer is affirmative, someone will have to pay to pick up the pieces.

He coyly insists he was just asking questions, but the book makes a strong and, in my opinion, one sided case that there is “evidence of harm” – specifically evidence that thimerosal was a major contributor to autism. It also builds a case for a grand conspiracy to hide this fact from the public. Kirby then made a career out of promoting the notion of a link between vaccines and autism with government and professional malfeasance. He became a hero of the anti-vaccine movement.

Yet he insisted, implausibly, he was not “anti-vaccine.” As recently as December 2007 Kirby was writing this nonsense in the Huff Po:

But if thimerosal is vindicated, or shown to be a very minor player, then what about other vaccine ingredients? And what about the rather crowded vaccine schedule we now impose upon families of young children? And what about reports of unvaccinated children in Illinois, California and Oregon who appear to have significantly lower rates of autism? Shouldn’t we throw some research dollars into studying them?

By this time the handwriting was on the wall – thimerosal in vaccines is not linked to autism.  After moving the goalpost several times on the evidence, it could be moved no longer. The removal of thimerosal from the routine vaccine schedule by 2002 was followed by a continued increase in autism disgnoses – without even a blip. The predicted (by Kirby and others) precipitous decrease in autism diagnoses never came.

Kirby and the anti-vaccine crowd moved quietly over to the other ingredients in vaccines, in what has been called their “toxin gambit.” This move, more than anything else, is what convinced me that this was all really about being anti-vaccine. The MMR vaccine was vindicated. Now thimerosal was vindicated. So there must be something else in those vaccines that’s the problem – even though there is no evidence to link vaccines at all to autism.

Now Kirby has quietly backed off even more. He writes:

I believe that most ASD cases have environmental triggers (probably more than one) that activate certain genetic predispositions (again, probably more than one) and create some of the symptoms that we call “autism.” I also believe that vaccines may have played a role in triggering some – though certainly not all – cases of regressive autism. Even if that number is a small minority, it seems sensible to me to study the mechanism of action, in hopes of finding clues to the development of autism in all those other children.

Kirby is slowing moving over to the position of the scientific community he has so long criticized for not listening to parents and being blind to the true causes of autism.  He’s not quite there yet, but now it is mostly a matter of emphasis. His position now seems to be that autism is a complex set of disorders with many genetic and environmental contributions. Congratulations – that is what scientists have been saying for years.

But Kirby has gone from – it’s the mercury, stupid to OK, mercury is bad, but there are other toxins in vaccines too, to scientists need to focus more on environmental triggers (but don’t forget about vaccines).  Even though vaccines “may have played a role” in “some” cases of autism, even if a “small minority” Kirby wants to make sure scientists are aware that this could be an important clue to the mechanism of autism. Thanks for the tip, Kirby.

That sure is a long way from claiming that thimerosal in vaccines was responsible for an autism epidemic. Don’t get me wrong – I am not criticizing Kirby for changing his position in response to new evidence. That is a good thing. I am criticizing him for being so far behind the curve while simultaneously promoting an already discredited theory and contributing to unwarranted fears about vaccines that is leading to demonstrable harm. And I am criticism his lack of transparency – slowly changing his position without overtly admitting past error, and arrogantly pretending as if he and the parents he claims to defend are pushing scientists in the right direction.

He writes:

I believe that the study of environmental triggers – other than vaccines – can provide some sorely needed middle ground in what has turned out to be one of the most contentious and vitriolic issues of our day. That doesn’t mean that research into genes – or vaccines – should or would stop. But it might provide for a way forward from here.

So now Kirby believes he is the beacon of light to show science the way forward. The scientific community has done well to just ignore Kirby and his ilk while they continue to do what they do best – think carefully and deeply about the evidence in the context of biological plausibility and let that be their guide. Scientists have been following their noses, and it has been consistently bearing fruit. Kirby and the anti-vaccine crowd have done nothing but provide a harmful distraction.

It is Kirby and others who have made this such a “contentious and vitriolic issue.” How disingenuous of him to decry that now, as if the scientific community had anything to do with it.  Now setting himself up as the peacemaker, Kirby writes:

People who ask questions about vaccine safety are now being called “pro-disease.” Some are supporting censorship of any talk about vaccines and autism. Yet many of these same voices balk and squawk at the very idea of researching potential factors like mercury from coal, live viruses, pesticides, aluminum, formaldehyde, jet fuel and many other toxins.

Calling Jenny McCarthy “pro-disease” is indeed hyperbole, but it is not inaccurate. She herself said:

I do believe sadly it’s going to take some diseases coming back to realize that we need to change and develop vaccines that are safe.

Call that sentiment what you will – she is OK with preventable diseases coming back until her arbitrary criteria for vaccine safety are met.

Further, neither I nor any of my colleagues are supporting censorship. Criticizing someone for expressing wrong and harmful opinions in public (and capitalizing on their fame) is not the same thing as saying they should be censored. This is not and has never been about censorship.

We are also not in the business (unlike Kirby) of telling the research community what they should or should not be researching. That is up to the experts to decide, and it is up to them to get funding for their research by convincing other experts that their ideas have merit. (I am an academic neurologist, and even I would not presume to tell autism experts what to research.) What we criticize is quite the opposite – it’s journalists and business majors telling scientists what they should research based on misinformation and hysteria.

So to summarize – after being a major force in helping create an atmosphere of controversy and distrust between some elements of the autism community and scientists who are honestly just trying to find answers, Kirby now decries that very atmosphere. He has reluctantly moved his own position from thimerosal to other toxins in vaccines to other environmental triggers, and now has the temerity to portray himself as the reasonable middle-ground.

The scientific community is right to just ignore Kirby and the mercury militia, and they would do well to continue to do so. The public interest is best served when science, not politics, determines the direction of scientific research – especially not the politics of fear, division, and conspiracy mongering.